痛みをコントロールするホスピスの有効性
JAMA
|May 10, 1985
まとめ
総合的なホスピスケアが,従来のケアと比較して,末期がん患者の痛みや症状を有意に軽減することはありませんでした. 痛みは鬱や不安と関連しており,緩和ケアにおける統合的な症状管理の必要性を強調しています.
科学分野:
- 緩和ケアとは,緩和ケアです.
- 腫瘍学 腫瘍学
- 痛みの管理 痛みの管理
背景:
- 末期がんの患者は,しばしば大きな痛みや症状を経験します.
- 症状管理における総合的なホスピスケアと従来の医療の効果については,さらなる調査が必要である.
研究 の 目的:
- 末期がん患者の痛みとがん関連の症状の管理における,従来の医療に対する総合的なホスピスケアの有効性を比較する.
主な方法:
- ランダム化統制試験設計. ランダム化統制試験設計.
- 患者は総合的なホスピスケアまたは伝統的な医療ケアに割り当てられました.
- 痛みはマギル疼痛スケールを使用して評価され,症状の頻度/強度は2年間の追跡期間または死亡まで記録されました.
主要な成果:
- ホスピスと対照群の間で,痛み,痛み強度,またはがん関連の症状の頻度/強度を経験した患者の割合において,有意な差異は観察されなかった.
- 両グループの患者の有意な割合は痛みがないと報告した (34%ホスピス対21%対照).
- 痛みのスコアは,鬱や不安レベルと有意な相関関係を示し,他の症状の存在と関連していました.
結論:
- 総合的なホスピスケアでは,末期がん患者の痛みや症状を緩和する点で,従来の医療よりも統計的に有意な利点を示さなかった.
- この研究は,進行がんにおける痛みと心理的苦痛 (うつ,不安) の強い関連性を強調しています.
- 身体的および心理的な症状の両方に対処する統合的なアプローチは,末期がん患者の効果的な緩和ケアに不可欠です.
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